The hemodynamics of septic shock: a historical perspective.

The hemodynamics of septic shock: a historical perspective. Curr Vasc Pharmacol. 2013 Mar 1;11(2):133-8 Authors: Feihl F, Waeber B, Liaudet L Abstract In the late 19th century, it was already known that severe infections could be associated with cardiovascular collapse, a fact essentially attributed to cardiac failure. A major experimental work in the rabbit, published by Romberg and Pässler in 1899, shifted attention to disturbed peripheral vascular tone as the mechanism of hypotension in these conditions. In the first half of the 20th century, great progresses were made in the pathophysiologic understanding of hemorrhagic and traumatic shocks, while researchers devoted relatively little attention to septic shock. Progress in the hemodynamic understanding of septic shock resumed with the advent of critical care units. The hyperdynamic state was recognized in the late fifties and early sixties. The present short review ends with landmark studies by Max Harry Weil, demonstrating the importance of venous pooling, and John H. Siegel, which introduced the concept of deficient peripheral utilization of oxygen, inspiring later work on the microvascular disturbances of septic shock. PMID: 23506492 [PubMed - in process]
Source: Current Vascular Pharmacology - Category: Drugs & Pharmacology Authors: Tags: Curr Vasc Pharmacol Source Type: research

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Conclusions In apost hoc analysis of the ADRENAL trial participants who fulfilled either the Sepsis-3 or the APROCCHSS inclusion criteria, a continuous infusion of hydrocortisone did not result in a lower 90-day mortality than placebo in septic shock.
Source: Anesthesiology - Category: Anesthesiology Source Type: research
(University of Colorado Anschutz Medical Campus) Researchers at the University of Colorado Anschutz Medical Campus have developed a unique model allowing them to predict which children arriving in emergency departments are most likely to go into septic shock, a life-threatening condition.
Source: EurekAlert! - Medicine and Health - Category: International Medicine & Public Health Source Type: news
In this study, we sought to determine levels of circulating thrombin in patients with septic shock. To characterize levels of circulating, active thrombin in patients with septic shock. 48 patients with septic shock were included in this prospective, observational study. Blood samples were obtained on admission, day 1, day 3 and day 6. Levels of active thrombin were measured using a standardized, clinically applicable oligonucleotide (aptamer)-based enzyme-capture assay (OECA). Thrombin levels were correlated with established indirect thrombin parameters, conventional coagulation tests, laboratory parameters, patient chara...
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research
To derive and validate a model of risk of septic shock among children with suspected sepsis, using data known in the electronic health record at hospital arrival.
Source: The Journal of Pediatrics - Category: Pediatrics Authors: Tags: Original Article Source Type: research
Sepsis remains a major public health problem with no major therapeutic advances over the last several decades. The clinical and biological heterogeneity of sepsis have limited success of potential new therapies. Accordingly, there is considerable interest in developing a precision medicine approach to inform more rational development, testing, and targeting of new therapies. We previously developed the Pediatric Sepsis Biomarker Risk Model (PERSEVERE) to estimate mortality risk and proposed its use as a prognostic enrichment tool in sepsis clinical trials; prognostic enrichment selects patients based on mortality risk inde...
Source: Science Translational Medicine - Category: Biomedical Science Authors: Tags: Research Articles Source Type: research
Platelet function during sepsis-related disseminated intravascular coagulation (DIC) is only sparsely investigated. We aimed to determine 1) platelet aggregation, independently of platelet count, and platelet activation among septic shock patients and 2) whether platelet aggregation or platelet activation differed among patients with and without DIC.
Source: Thrombosis Research - Category: Hematology Authors: Tags: Full Length Article Source Type: research
We report a case of a 59-year-old female patient with vegetative native mitral valve endocarditis caused by Stenotrophomonas maltophilia (SM). She had hemodialysis-dependent chronic renal failure, but no immunosuppressive disease. Echocardiography showed mobile vegetation on her native mitral valve. Right femoral artery embolectomy and mitral valve replacement were performed simultaneously. She awakened from anesthesia, but she passed away due to septic shock complications. To the best of our knowledge, this was the first case in whom native mitral valve endocarditis caused by SM was observed (despite of absence of any imm...
Source: Revista Brasileira de Cirurgia Cardiovascular - Category: Cardiovascular & Thoracic Surgery Source Type: research
Bradykinin is a proinflammatory factor that mediates angioedema and inflammation in many diseases. It is a key player in some types of hereditary angioedema and is involved in septic shock, traumatic injury, Alzheimer’s disease (AD), and stroke, among others. Activation of the plasma contact system leads to elevated levels of...
Source: Proceedings of the National Academy of Sciences - Category: Science Authors: Tags: Brief Reports Biological Sciences Source Type: research
Publication date: Available online 9 November 2019Source: Journal of Critical CareAuthor(s): Daniel Colon Hidalgo, Jaimini Patel, Dalila Masic, David Park, Megan A. RechAbstractPurposeMortality rate for septic shock, despite advancements in knowledge and treatment, remains high. Treatment includes administration of broad-spectrum antibiotics and stabilization of the mean arterial pressure (MAP) with intravenous fluid resuscitation. Fluid-refractory shock warrants vasopressor initiation. There is a paucity of evidence regarding the timing of vasopressor initiation and its effect on patient outcomes.Materials and methodsThis...
Source: Journal of Critical Care - Category: Gastroenterology Source Type: research
Publication date: Available online 9 November 2019Source: IDCasesAuthor(s): Lin Wei-Chen, Chang Ching, Ko Meng-Cheng, Lin Shu-MinAbstractAcute varicella zoster virus (VZV) infection is a common condition in children, which is considered a mild, self-limited disease with diffuse skin vesicular rash. However, disseminated VZV infection with multiple organ involvement can occur in immunocompromised patients with impaired T cell immunity including solid or hematopoietic stem cell transplant recipients, receiving immunosuppressive therapy, leukemia, lymphoma, and HIV infection. Prompt antiviral therapy is mandatory in those imm...
Source: IDCases - Category: Infectious Diseases Source Type: research
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